On Hypnosis for Depression

Depression is an umbrella term for the presence of several symptoms rooted in dysregulated mood. At its core, depression includes either low mood, loss of interest or pleasure, or both [1]. Among the other experiences people with depression might have are insomnia or hypersomnia, fatigue, lack of motivation or enjoyment, concentration difficulties, changes in appetite and weight, and suicidal thoughts or behaviors. Every year, approximately 1 in 14 adults in the U.S. experience clinically significant depression with significant distress and impairment of life quality and functioning (i.e., Major Depressive Disorder) [1]. Depression rates are three times greater in young adults (18-29 years old) than in older adults (+60) and twofold more common in women than men. Depression rates are on the rise, with significant increases in prevalence from 2005 to 2015 [1] and even higher numbers since the COVID-19 pandemic [2].

Can hypnosis help with depression?

A recent meta-analysis (a statistical summary of findings across studies) found that people who received hypnosis showed more reduction in depression than about 76% of those who received other task assignments (control conditions) and more than half remained improved at the longest follow-up after the treatment ended [3]. The findings suggested that hypnosis is a very effective approach for reducing depression and appears as effective as common treatments such as cognitive-behavioral therapy (CBT) [3].

Hypnosis is particularly helpful in decreasing excessive focusing on distress (i.e., rumination) and may assist in addressing helplessness and hopelessness as well [4]. Moreover, hypnosis can be used to support the learning of new skills, a key aspect of all evidence-based psychological treatments for depression. This improvement also reduces the chance of future episodes of depression [5]. This is understandable because both depression and hypnosis can affect expectancy; depression is associated with expecting negative outcomes or the lack of positive outcomes while hypnosis can be used to improve one’s outlook [5].

Why is hypnosis a better alternative for depression?

More than 1 in 8 adults in the U.S. have used antidepressant medications in the past month. The likelihood of being prescribed an antidepressant increases with age, with the highest among women above 60 (almost 1 in 4) [6]. Of those taking psychiatric medication, more than 4 in 5 people use medication long-term. Long-term use of antidepressants has a wide range of side effects, with potential symptoms such as dry mouth, constipation, weight gain, and sexual dysfunction (depending on the type of drug) [7]. Importantly, the claims that antidepressants work by correcting a neurochemical imbalance (e.g., insufficient levels of serotonin in the brain) have been challenged [8]. Clearly there is a placebo component to antidepressant benefits, for the very reason that there is widespread believe in the efficacy of these medications among doctors and patients. Indeed there is reason to believe that depression might be particularly sensitive to hypnosis because both hypnosis and antidepressant medications work in part through shared mechanisms (e.g., expectancy) [9]. Moreover, hypnosis is safer than most medications and, as noted in The American Journal of Medicine [10], “if hypnosis were a drug, it would be standard of care.”

Bottom Line

Hypnosis can be very effective in reducing symptoms of depression such as negative expectations and low energy. It is likely as effective as mainstream psychological treatments for depression, such as cognitive-behavioral therapy, may decrease the likelihood of relapses, and has fewer side effects than most psychiatric drugs.

References

1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders Fifth Edition Text Revision (DSM-5-TR). (American Psychiatric Association, 2022).

2. Salari, N. et al. Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis. Glob. Health 16, 57 (2020).

3. Milling, L. S., Valentine, K. E., McCarley, H. S. & LoStimolo, L. M. A Meta-Analysis of Hypnotic Interventions for Depression Symptoms: High Hopes for Hypnosis? Am. J. Clin. Hypn. 61, 227–243 (2019).

4. Yapko, M. Hypnosis in Treating Symptoms and Risk Factors of Major Depression. 30, 14 (2009).

5. Yapko, M. D. Hypnosis in the Treatment of Depression: An Overdue Approach for Encouraging Skillful Mood Management. Int. J. Clin. Exp. Hypn. 58, 137–146 (2010).

6. Brody, D. J. Antidepressant Use Among Adults: United States, 2015–2018. 8 (2020).

7. Bet, P. M., Hugtenburg, J. G., Penninx, B. W. J. H. & Hoogendijk, W. J. G. Side effects of antidepressants during long-term use in a naturalistic setting. Eur. Neuropsychopharmacol. 23, 1443–1451 (2013).

8. Kirsch, I. Antidepressants and the placebo effect. Z. Für Psychol. 222, 128 (2014).

9. Kirsch, I. & Low, C. B. Suggestion in the Treatment of Depression. Am. J. Clin. Hypn. 55, 221–9 (2013).

10. Kittle, J. & Spiegel, D. Hypnosis: The Most Effective Treatment You Have Yet to Prescribe. Am. J. Med. 134, 304–305 (2021).

About the author:

Afik Faerman, Ph.D. is a postdoctoral scholar at Stanford University. He completed his doctoral training in clinical psychology with an emphasis in neuropsychology, and his clinical training at the University of California, San Francisco (UCSF) and Baylor College of Medicine in Houston, TX. Afik’s research centers on identifying key neurocognitive mechanisms in clinical change, focusing on hypnosis, pain, and sleep. His research was supported and acknowledged by the American Psychological Association, the Society for Clinical and Experimental Hypnosis, and the American Society for Clinical Hypnosis.